Medicare vs Medicare Replacement Plans with Bruce Muller

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Bruce Muller Bio:

Bruce Muller is a S.H.I.P. counselor and is passionate about helping others navigate their options when it is time to get into Medicare. 

Links:

https://www.shiphelp.org

https://medicare.com 

Joel

So, it’s really kind of, you know, it’s easy, there’s really, you know, no complications. I’ve never heard of a case where their supplement didn’t follow them properly or do what it wanted to do. Now the supplement will only cover Medicare. You know related services. So, you know they’re not going to cover a facelift. Whatever the case might be. But as long as it’s something that you know, Doctor Who is a Medicare doctor who prescribes whatever the situation is. You know that’s going to follow you. 

So, there’s no worry. You go to the emergency room. You know show them your cards and you’re all. Set to go. And again, the Only thing is, yes, those will get the price here as time goes on. But again, it’s, you know, I want to say deluxe service. Many people will refer to Plan G, another one is Plan N which is generally for people who are healthy and don’t go to the doctor very much. They might have a little bit of savings there because they’ll have a copay. When they go, G is by far the most popular, and again a lot of people call that, you know, the Cadillac plan. 

Joel 

So, Part G is that in. The drug plan you’re talking about, it’s part of. 

Bruce 

No, that’s your, that’s your supplement. 

Joel 

OK, so these are different supplement ideas, yeah. Can you switch supplement plans? 

Bruce 

So, when you get a plan G, that’s the supplement. You know when you call up, you know, United Healthcare, and you tell them “I need a supplement plan and I want plan G” They know exactly what you’re talking about. And they will show. You the different costs and plans. 

Joel 

So, if the supplements have different plans, you know some maybe are better for healthier people, and some may be for people who have more issues. Is that something that people do? Can switch between them after they initially sign up or are they stuck with it? 

Bruce 

Generally, know you can. However, after that initial six-month guaranteed period. Now if you want to change the company can underwrite you. And that’s one thing that will. Hopefully, I don’t confuse everybody, but we could talk about it right now with an advantage plan. Yes, there’s original Medicare and there’s an advantage plan. 

You can switch down the road. However, if you’re on an advantage plan, you want to go back. To original Medicare. And it’s two years down the road. Now that company can underwrite you and look at your health and say “Please Bruce, you know. You had a heart attack. And a stroke. And you know, we don’t want you. Or here’s the cost”. Which I would probably interpret as I don’t want you either, so, so you know you have to face that. 

However, when you’re on original, excuse me, when you’re on original Medicare and you want to go. To an advantage. Plan. You can go. Well, during the open enrollment period, which is the appropriate time? 

So, an advantage plan will always take you. So, you know, we always hear, yeah, you can go. But sometimes people take advantage of a plan, and they think well. If that doesn’t work out and there are some problems with it, well then, I go back to my original Medicare well. In theory, you can, but in practicality, you can’t, because again, you’ll be underwritten and that’s one of the things we stress you know. No, I don’t know about all of you folks that I’m a great procrastinator. I’m a professional procrastinator and people think, well, I’m going to turn 65 in January. I have plenty of time. OK, I signed up. Yeah, I’ve got six months to sign up for that supplement. And before you know it, that six months is up. 

And maybe you have a health issue that’s going to really prevent you from getting a plan now your only choice is an advantage plan, so we always stress people. Keep your wits about you, but you know many people start calling us, you know. A lot in advance because it’s as much a healthy decision as it is a financial decision too. So, you just want to keep your wits about you, and you know and sign up. You know when it’s appropriate. 

Joel 

So, it sounds, it sounds to me like with these supplement plans and we’re going to talk more about those advantage plans in a little bit, but on the supplement plans where they have different versions that you can get that if. You do choose one over another that people should probably take a longer view and they might say I’m healthier right now, but you know, if I’m going to have this thing for the next 30 years, then I can’t change it. They definitely should consider the fact that you know their health may not stay the way that it is when they initially signed up for the plan. Because generally. You know, there’s a lot more people alive at 65 than at 100, so you know, something usually happens between those two ages. 

Bruce 

Yeah, well, well, exactly. And we men, are the worst about that, but I don’t think any drugs right now. 

Joel 

Well, especially if you are automatically enrolled. I mean I could easily see myself. Oh, I’m automatically enrolled in Medicare. I’ll just let that happen and then you have six months that kicks in right away. It sounds like, right? So, you’re going to have to do anything, and your clock starts. 

Bruce 

If you’re taking like, already on Social Security, that’s going to kick in and then you, you might think, oh, I got my Medicare. I’m all set when in fact you haven’t looked at it and seeing that wait, I have Part A and I Part B, but I didn’t get a Part D. I mean, there are people that say, oh, I didn’t know I had to get a part D, I thought that was all rolled into one. 

Nicole 

And Bruce, just to clarify, when you’re saying underwriting, you just for anybody that maybe doesn’t understand, I want to clarify for myself. You mean that prior to that six-month window, they can’t take into account any of your preexisting conditions but outside of that six-month window, now they’re going to rate you hire based on your health condition. 

Bruce 

Yeah, I mean, I mean, I had a lady a couple of years ago that would that we called needed some help. And she had been just diagnosed with stage 4 lung cancer. She could do whatever she wanted because nobody could. You know, nobody could turn it down. 

Nicole 

Right. 

Bruce 

So again, that’s why it’s important and you know not to procrastinate, but to get it under control. And I think most of most people are pretty good about getting it under control because you know nobody, nobody wants to go without proper health insurance. I always compare it to my car and house insurance. I won’t back my car out of the driveway unless all my insurance is properly in place. I mean, you know. I just got to drive around the block. I’ll be OK. 

Nicole 

Right. 

Bruce 

So I think most people are really pretty good about getting a handle on It. And in fact not to get too far off track, but I just came back from working with a group of seniors who are all over 65. And we played our version of Medicare Bingo, which is like playing bingo, but you just have to answer the questions in order to win our little prizes. But that’s how we go about and educate people. And before you know it, somebody saying wait now, I don’t understand that. Well, do I have this or that? And you know it generates all questions about what kind of coverage they do have; because a lot of people don’t know what coverage they have because, in a lot of cases, somebody has told them, “Hey, this is what you ought to do” and they do it, and if they have any problems, you know, they think they’re all set, you know? 

So, we’re all we are all set until we find out we didn’t do things properly. So, you know, assuming somebody wants to go on original Medicare again, they’re going to have the different parts and they get their supplement and their drugs. Now, that doesn’t mean that they’re done forever because we still want them… They’re open enrollment period. That’s in the fall, October 15th – December 12th. That’s when we want them to look at their drug plan, because somebody may have a lot of drugs, you know, they’re what we call a walk-in drug store. They may be taking 25 drugs and they haven’t checked to see what the price is. I did have a case to one through one of our counselors where a lady was paying $33,000 out of pocket on drugs. Came to us. We checked it out and found a plan that they were almost all covered except for I think around $1000. 

So even though you’re on original Medicare and you think you’re all set, and you know, yeah, you’re griping about the cost of those drugs, but check them out every year. It doesn’t cost you anything to, you know, to check it out. That’s why in Part D we recommend especially – well the whole thing –  We recommend you get an online account. 

So, you know, we do recommend that you, you know, you check your plans in the fall to make sure that you’re getting, you know, everything that you should have. Again, like this lady that happened to her, and she just she… the good news is she had the financial wherewithal to pay for it. The bad news is that she had the financial wherewithal and never checked it. So again, with the original Medicare, you’re going to have your various parts and you know you’re basically all you know, you’re all set to go. 

Now the alternative and these are what you see advertised on TV and a lot of people talk about what we call the Medicare Advantage plans. 

Joel 

Hey, Bruce, can I just cut you off for one second? So just to kind of recap traditional Medicare, it sounds like if you are turning 65 and you’re getting on Social Security, you’re going to be enrolled automatically for Medicare. And when that enrollment happens, you have six months in order to choose a supplement plan from that enrollment as well as to get on the Part D medications. And get into that. 

Bruce 

So, you don’t have a part, you don’t have the part. You don’t have six months for Part D, you have to do that you know. You know right at this time you enroll. 

The only one that has an extended time period. 

Joel 

  1. And then and then for the cost of Medicare, they’re looking at Part A is free, and Part B has $165 (right now … It’s currently you know this that may change in the future) A month and that is no matter what else you do. You have that fee for Part B and then above that it’s cost-sharing. It’s 80/20. Medicare covers 80%, and you cover 20% unless you sign up for a supplement plan or this advantage plan that we’re about to talk about. So that is kind of that the other cost is going to be drugs, which is basically cost. It’s basically a discount plan for you. 

So, somebody, somebody looking at the total cost of Medicare may be compared to their own current plan, they’re looking at right now, $165 plus what other whatever the supplement is, which we get in the timeline shouldn’t be too bad because it’s just about age and whether you smoke and stuff like that. And then whatever it is with the discount drug plan. So that’s kind of the recap of traditional Medicare. And then from this point, why don’t we launch into the advantage plans and let you talk a little bit about that. 



Bruce 

OK, so it’s an advantage plan. You’re still on Medicare. It’s just another way of taking your benefits. So, the basic difference is that Advantage plans operate with a network of physicians and other services such as rehab facilities. 

So, you do have to make sure that your physician is in their plan. And the plans are set up. There’s either what we call an HMO and health maintenance organization, or a PPO, which is the preferred provider now. An HMO has a little bit smaller network of physicians. The major difference is that you’ll have a primary physician and if you need to go to a specialist, then you do have to get permission from the primary to go to a specialist, whereas with a PPO preferred provider, you don’t. You have your primary physician and then you can go to a specialist if need be. Now there’s no premium to most of those plans. Some of them might, but in general, most of them don’t have a premium. 

So, again you have to make sure that the physician, you know, the hospital well, almost all hospitals are in you know in all the plans. And then the other service. That you use, you have to make sure they’re in, you know, in that plan. 

Now in place of the 80/20. You will have what they call a maximum out-of-pocket expense. And that can be up to $8,900 a year depending on the plan. The way that works is, let’s say your plan was whatever insurance company has a maximum out-of-pocket of $4,000. Then once you reach that amount, not including your drugs. Then everything is covered. 

So, once you reach that $4,000 or whatever the company is, you know some of them are higher than others. But the maximum allowed by you know the law, the Medicare law if you will be $8,900. So once that covered, once that’s covered, then everything else is covered except, you know, except for drugs. 

There are lots of times… Again, if you’re an HMO, you do have to get permission or pre-authorization to go to another specialist and maybe some other services too. You might have to have that, but in general, there’s no premium except for of course we get to the drugs. A company might have 0 premiums. Or they might have a premium. It just depends on the company. 

And again, even with an advantage plan, it’s basically a discount from you know the cost of the drugs. And again, you know people talk about using you know one of the little coupon services that “Oh yeah, I use that you know, and I’m fine”. That’s not always the case. Again, if you, know something goes wrong and you need the heavy-duty drugs and you certainly want to have coverage in some way you know some form of Medicare. So, you know. It is but again those are built in. 

Joel 

Do these advantage plans replace Part D as well? Then they have their own schedule for drugs. 

Bruce 

Yeah, yeah. That will be your part D will be built into your advantage plan, so it’s kind of an all-in-one, it’s kind of a one-stop shop you know with some you know like I said with some limit limitations. One of them is If you go to Oklahoma and you have an emergency. You’re covered by the emergency. But let’s say you go to you go someplace you want to live for six months, but you have a situation where you need to go to the doctor periodically. Then you need to find a doctor in your plan, or you will have to pay the rate that is, out of plan. So that’s a little bit different than the original Medicare because again the original Medicare goes to anybody. 

Joel 

That actually reminds me of a story of somebody that I know whose mom was flying out to visit them for extended periods of time, and there was a point where she had to cut the visit short because she had to fly back because she had to see a specific doctor back in their hometown. It sounds like I didn’t really put two and two together at that time, but it sounds like that’s a Medicare Advantage issue where they had the HMO. 

Bruce 

Yeah, well, some of the companies now do have the ability, but I’m not sure which ones you know are that you can go to, you know, say it’s United Healthcare, you can go to a doctor, and you know Timbuktu, that takes United Healthcare. But I’m not sure just how widespread that is. 

Where it kind of breaks down too. Like for instance in my state there are some areas where they’re in between. You know, they’re saying more rural. But you know they’re in between two major cities and you know, where do they go? I go to this city for some things and then to this doctor. I go over here. 

And so, you know when you’re in a metropolitan area you can get to pretty well any doctor. That you need, but when you live, you know, just live in some other areas where it’s harder to get doctors, then it, then it becomes a problem and where you know, there’s a definite advantage to it, you know, to an original Medicare. 

But those plans, again, you have to have, you have to be in the network and then you’re going to in place of the 80/20, you’re going to have a maximum out-of-pocket. You may have some copays on various things. Most of them don’t have a copay for a primary physician right now, but you’ll have maybe a $40/45 copay for going to a specialist and now those are the plans. That will offer you some dental and vision and some hearing, but most of them offer all three on a varying scale. 

But again, the doctors have to be within that plan and some of them, some of the companies, call an 800 number and they’ll tell you who’s in the plan that day. And you know, and that’s a decision too, you know. You know, when you get to be a certain age, like me, if you can’t tell from my picture. I don’t want to switch my dentist. 

So, it doesn’t mean anything to me, whether my dentist is in, in, or out. You know, if he were in a plan that I chose great, but if he isn’t, so be it. Because I don’t want change, I have an eye condition that if I changed eye doctors, I would face days of examination and explanation and trying to, you know, get the lay of the land. No matter what, I don’t want to switch my eye doctor. 

So that that decision enters into it, I mean you know, a good dentist is a good dentist, but a lot of people, you know, like the one they’ve been going to, you know, they’ve been following them for the past 70 years. So that’s a decision you have to make. 

The other thing is and let’s say a plan says you have a $1,500 benefit. Well, that doesn’t mean you’re going to get a full $1,500. They’ll say your dentist’s charge is $300.00 a surface, but the plan might say whatever is reasonable and customer, that’s what they’re going to pay you. So, you know that 300 surfaces might only get you $150.00. So that doesn’t mean you’re going to get $1,500 worth of service. Do you know what I’m saying? 

So, but what’s there, and for a lot of people, you know it’s good. You know, some, you know, get a couple of cleanings a year, and then some other benefits may be on the eyes, you might get an eye exam or two a year. You know, go from there. Now, some of them will offer some other things too. You might see some trips to the doctor. You might see some other costs that you know they might cover, and that’s up to the individual plan. And so, you know, you have to have to look at those. 

Generally, they’ll give you a list of all these things that you can get other than vision, dental, and hearing, you get to choose three of them. But then you know, then it’s up to them to decide whether or not there, you know, going to give, you know, some of these extras to you. 

So right now, let’s say you choose an advantage plan six months from now… It’s just, I don’t like this. It’s not working for me. You have a year’s trial, right? So, within that year period of time, you can go back to your original Medicare. 

Nicole 

Do you have to do that during open Enrollment, or can you do that at any time? 

Bruce 

That’s, you know, if I sign up now for a medic, you know, for an advantage plan, I have a year from today to do that? 

Joel 

So that’ll let you go back into the supplement without having to get underwritten again if it’s within that year. Do you have to be on the supplement first and then transfer over and transfer back?

{34:13} How to change advantage plans

Bruce 

No, no, no, you, this is what they call a trial right? And what you were asking about, do you have to do that? In the fall. Fall is when you decide well. I don’t like the advantage plan I’m on. I want to change to a different Advantage plan. Now you can change plans.

And during that open enrollment, you can change 15 times. The last one at the You know 5 minutes to 12, you know, that’s the one you’re going to have. With an advantage plan too, though, there is a special enrollment period. Let’s say you signed up for one, you know, during the fall open enrollment. And then January 1st, you discovered that “Oh my God, my doctor’s not in my plan after all” You have one more shot to change that plan. But only one. 

So, if anybody does that, you know you have got to be really careful because you only get to press the button on the computer one time. And once you make that change, you’re stuck with that plan for the year. 

Nicole 

One of the things that I wanted to add that I’ve seen with some of these Plans is I know what you’re saying. They can go in and out of network for doctors as long as they’re in their network, but when it comes to things like home care and durable medical equipment, someone comes in with Medicare and that’s a pretty straightforward thing we know what Medicare is going to do, we can go ahead Send out the wheelchair or whatever type of medical equipment we can go ahead and get started in the home health episode. 

When we run into these advantage plans, we’re having to ask, we’re having to send in clinical. We’re having to wait for prior authorization, which is delaying the care or delaying them getting what they need. Yeah, in some cases, instead of the 80/20, maybe they can go out of network. And now they’ve got a 60/40. 

So, there are just some different things that tend to be a little shocking when I run into some of our clients or patients that have one of these advantage plans, they don’t seem to understand the full picture. 

Bruce 

Well, everybody gets blinded by the no, you know the no premium. 

Nicole 

I heard you say that. Are you saying that the $165 that they pay when they’re on Medicare, they don’t pay or they don’t pay? 

Bruce 

No, no, no. Everybody pays that. But I’m talking about an additional premium. 

Nicole 

They pay no additional premium, no matter which plan they. 

Bruce 

In most cases, you know. 

Nicole 

Decide OK. 

Bruce 

Yeah, except for the drug plan. The drug plan, they’re probably going to have a premium. 

Joel 

So the supplement cost, which would? Start probably around well right now, probably around 100 to 110, you know might be more in the future that they don’t have to pay. 

Bruce 

Right. 

Joel 

So it sounds so if they try to go from an advantage plan back to regular Medicare, they have to get underwritten for the supplement, but if they’re in an advantage plan and they want to switch to a different advantage plan, do they get underwritten when they do that switch, OK. 

Bruce 

No, no, no, no, no, no switch. No switch from that. 

Joel 

And then the other question I had was that that was coming up, you’re saying some of these advantage plans cover vision and dental, hearing. So, with regular Medicare, does regular Medicare not cover vision, dental, and hearing at all? 

Bruce 

Right. No, no. There was talk this year was going to get some dental, but it didn’t happen. But you know, original Medicare and Medicare in general this year, the vaccines have all become for the most part, no charge. For instance, the big one that there is no charge is shingles. In the past, the shingles shot could cost a couple of $100 * 2 shots. When we’re talking to somebody, we’re always preaching, you know, get the shingles shot because that is one nasty illness. You know it’s important.

So, you know a lot of things like. You know like that. Have changed mammograms no more than a couple of years ago. Mammograms and calling that has to be those used to have a copay and a lot of people don’t have enough money for the Copay or I don’t want to pay a copay, so they did away with that. 

So, on the first screening of both of those things. You don’t have to have a copay anymore. It can make your head like, oh my gosh, you know, what do I do? And I compare it to any kind of like my house insurance or even my car insurance. Let’s say I carry a high deductible on my house because I think the chances of my house having a fire are slim. Hopefully, you know where I live. We’re always going to have hail damage and so you know, you know, within your lifetime of living in Indiana and owning a home, you’re going to have hail damage at some point. So even though I have a high deductible, I do have to realize at some point in time if I have that need, I’m going to have to cough up some money. So that those savings that I have, I may have to give back at some point in time. 

So, you know, it’s kind of a financial decision whereas you know, yeah, you know, I’d be like having my car insurance. And you know, I’ve got a plan that covers and covers a blowout, or an engine blow up with no deductibles or anything because I pay, you know, I have the plan, I’m set to go. So, it’s kind of similar to that situation. 

Joel 

Just we’re laying this back to the advantage plan, the advantage of the advantage plan as it seems to me is that one that is probably the one that’s most pushed is that you don’t have to pay the supplement fee which is somewhere between 110 or more depending on how old you are. And then you get some sort of benefit, depending on the plan for the dental vision and hearing that you wouldn’t get under Medicare and that seems to be the main 2 advantages is that you get some assistance with those things, and you don’t have to pay the other ones. Are there other advantages from the advantage plan that I’m missing? 

Bruce 

No, I would. I would say that’s pretty accurate. 

So, there are the perceived savings, you know, with not having to pay them for the supplement plan, you get these other advances, you know, you get those other things in there. You know, there are some trade-offs to it and having to pre-approval on the different you know a lot of different things or procedures. Being denied and then you have to appeal it. 

Joel 

Yeah, that’s what I was going to go into next was the disadvantages of the advantage plan. So, it sounds like on the cost side. If you are, say, 65 and healthy, the advantage plan may actually have some pretty significant advantages, and you don’t have to pay the deductible and you know the copays you do have to pay. There’s a catastrophic cap on them, and the catastrophic cap is much higher than your deductible would likely be if you needed to use it. 

So, the potential cost of the advantage plan is much higher than the flat cost of the supplement for most people. At the beginning when you’re 65, you’re probably not going to be using close to that catastrophic cap, and then you get that extra financial benefit of the hearing and all of that. 

On the downside, let’s say you’re older. Say you are in the 70s going into the 80s. You know most of us have loved ones that are in that range. Right now, you know, medical issues seem to become more severe and more expensive. It seems that the advantage plan is likely in those later years to be more expensive.

And then the other downside is that the freedom that you were talking about, the freedom to use the specialists you want, to go to the doctors that you want? If you like to travel, being able to travel and get seen and get patients or get getting to see doctors wherever you are. 

So, if you don’t like to travel and your kind of in your home area and you and you’re in like a metropolitan area with a lot of service providers, maybe that’s not a big deal. But if you’re in a more rural area, maybe they don’t have the specialists you need in your network, or if you like to travel, there could be some big drawbacks to using the Advantage plan. 

Bruce 

Yeah, I think that’s yeah, I think that’s a pretty good summation. 

Again, don’t forget you know an advantage plan. This is what we refer to, as managed care. So they get to have a little bit more say in the management of your care. 

Joel 

Under managed care, the insurance company that has the Advantage plan is managing your care, not you. Whereas under regular Medicare you manage your own care basically. 

Bruce 

You know that’s, you know, that’s, you know. Just you know, it’s harder than you know buying your house, your car insurance. You know, you have got a few basic questions about your house and car insurance, you know, with my, with my car insurance… Well, it’s old and it’s not worth much, so I don’t have to carry collision or whatever on it because you know, if somebody runs into it, so be it, you know, so it’s a little different.

Where with the human body, no matter how old it is, you know, you need to carry, you know, the proper coverage. So, it does become just a little bit more. You know, complicated as to, you know, making the decision. 

Joel 

Well, the thing that makes the decision really important and why it’s so important, people arm themselves with as much information as possible so that they can start with Medicare and with the supplement plan that is guaranteed. If you go to the Advantage plan you have one year to change your mind and after that, if you go back to try to go back to Regular Medicare because you need that freedom or you want to travel or the specialists you need aren’t in your network, when you try to get that supplement plan, they are going to reevaluate you for every medical condition you have, and it’s likely going to be incredibly expensive to make that change. Whereas if you can just lock it in and keep it early on, you can keep those costs down for the long run. 

Bruce 

Yeah, you’re right. You know, that’s part of the, you know, part of the thought process. And one of the things that I always tell people to do is you know you really need to do your own homework and make up your own mind. Now don’t ask all your friends what you know what they do. How do they take them? Well, you could, but you have got to realize, you know, they’ve got an opinion and an experience. Your health situation might be different. 

Also, two, if you talk to a friend and you know in California or wherever and they love that with whatever plan that plan might not be available in Indiana. Or wherever you live, so the advantage plans are. All by county across the country, so just because you know your sister and wherever likes her advantage plan wherever she lives, that doesn’t mean that you can get that same plan, you know, wherever you live. 

Joel 

So, I wanted to go into a couple of questions that we had. Did you have anything else you wanted to add to this, or do you think we covered the basics pretty well? 

Nicole 

I think Bruce covered the basics really well. I would just encourage people to ask enough questions when they’re looking into these plans and verify their doctors and their places. They’re in the network themselves and do not necessarily just take an agent’s word for it. I would just be fully informed before you make a big decision like that would be my only thing. 

Joel 

Yeah, I would say, you know, I thought just occurred to me that it probably is really important you do your own research because the Advantage plans have big insurance companies behind them, and they can’t afford to advertise or has Medicare, I don’t think probably do a lot of their own advertising, so if you’re looking, if you’re just doing searches and whatnot. You know, your searches might be more geared towards the Advantage plans than the regular Medicare because the companies that have those are for-profit companies that have financial incentives to enroll people in those. 

Bruce 

Yeah. You kind of have to make up your, you know, your own mind. Now, one of the new things that Medicare has started is, these ads on TV, where I don’t know William Shatner, who’s ever is advertising the, you know, plans they have to. I think the rule is now it has to be a specific insurance company before they were just pooling it all. You know, whatever insurance companies were part of the program, you know, they get to call you. And the other thing is if an insured person is showing you a plan and they work just for, I don’t know, for lack of a better, they have to tell you that, you know, I work for a sole company. There could be better options from other companies. You know, it’s become a little bit more straightforward, you know, about how. This all works. 

Joel 

And you know, the thought occurs to me that the call that they should probably make regardless is to a S.H.I.P counselor to talk about this stuff so that they can get some good advice from an expert in the industry that isn’t doesn’t have a financial incentive either way. So, you said the S.H.I.P counselors are all volunteers. That’s quite the calling. 

Bruce 

Well, except there are certain organizations, area agencies on aging and things where they are, you know, they have a paid staff, but the people who work for us, if you will, or a S.H.I.P councilor, they are all volunteers. They’ve gone through extensive training to learn about Medicare. My wife hears me talking to my volunteers on the phone and she said I just don’t. I don’t know why somebody volunteers for this because it’s difficult. 

Joel 

It’s a calling. 

Bruce 

But you know, for instance, the volunteer that saved that Lady $30,000. She’ll be a volunteer. So, she can’t do it anymore. In fact, many of our volunteers are in that boat. A couple of years ago, I had one that Johnny was turning, I think 83 or 84. And he said, you know, Bruce, I have got to give this up. I’m just afraid I’m not. You know, I might miss something that I shouldn’t miss. 

But people volunteer because they’ve been helped. They want to pass it on. Because they know what they’ve gone through and what we’re talking about tonight is a really pretty simple situation. And I know if your new it sounds complicated, but there are a lot more other issues that pop up that you would think by now with Medicare, there’d be nothing new that is tough to answer, but it happens, to try and figure out what their situation is. 

It’s a great Service, you know. I’ve taken phone calls before where somebody said, well, I talked to an agent, and this is what he told me. Yep. You’re correct. You’re you know. You’re good to go. You know, all your information is correct. 

But the S.H.I.P organization, you know people do call us with other, you know, kind of get involved in some other things, but you’ll never, you know, find a S.H.I.P agent, say, geez, that’s sorry, we can’t help you. Almost all of us will go well. Let’s see if we can, you know, find some help for you in this situation. And we’ll do our best to try and help someone. You know, no matter what the, you know the situation is. 

Nicole 

And for those of you that don’t know, the S.H.I.P stands for State Health Insurance Assistance Program. You should be able to Google any area that you’re in to find your shift counselors. 

Bruce 

If you go to https://www.S.H.I.Phelp.org/. So whatever state I’m in you’re seeing me, and if you go to, that will help you find your Local S.H.I.P site. And now one of the things to be careful of. We like it if somebody has got the wherewithal to, you know, do their own computer search and everything. We recommend doing that and we give you your initial information, and then you can go on and, you know, research more. But boy, we warn you, make sure you’ve gone to if you want to go to Medicare, the Medicare site go to medicare.gov or the S.H.I.Psite.org. I’ve had people who didn’t realize what they were doing. And you know how it is when you’re searching for something online. Well, they’ve seen this information that looks like unbiased information, but it’s an insurance company. And before you know it, they’ve given them there, you know, their Medicare number and their date of birth and everything. And now they’re captured so. 

And so, the information might not be what you’re looking for, but we’re worse than that now. They’re now, they’re captured, and they’ll become your best friend on a daily basis. 

Joel 

So, I think we covered most of the questions that I have, but there is one that I thought I might ask. That was submitted. If you can’t afford to pay for the Medicare monthly fee, what happens? So, if you can’t afford the premiums, what can people do? 

Bruce 

Well, if your income is in a certain bracket, then you can apply for what we call an extra Medicare Savings Plan MSP. And for instance, in Indiana – Now this varies from state to state – So in Indiana if somebody’s making less than $1,800 a month or $2,200 a month? It depends. Then, either with those amounts, they could get them you know that $164 or whatever they could get that paid for. And then that also ties in that’s a state program. And then that also ties into a federal program called extra help and that will help provide. A lot of relief for their drug costs. 

Joel 

And what about the supplement plan? Is there anything that helps with that if they’re on the supplement? 

Bruce 

So again, that makes a situation where once they have to, you know, have to go to an advantage plan because you know, I don’t have the financial wherewithal to do a supplement. 

Joel 

And then you know the last thing I just wanted to ask, you know that you have some expertise in this area, what types of scams should seniors look out for when it comes to Medicare and Medicaid? You know, people trying to take advantage of them, especially when they’re trying to enroll, there’s a lot of personal information that gets passed around in enrollment, I’m sure. What should people look out for? 

Bruce 

Yeah, and that’s one of the disadvantages when you call a company, very few of them will give you any information until you’ve given them your information. You’ll get phone calls… Medicare directly is never going to call you, so it is illegal for somebody to call you and say I’m with Medicare. You know, they had to identify and also now those calls are being recorded so that if agents are whoever’s called you have misled you, you know, there is some relief that you can get. 

So, you know the main thing is you know. If you get a call and somebody says it talks about your Medicare. You really don’t want to talk to somebody like that. Because they’re just dialing for dollars. And a lot of those calls, you know, for a person that says you, you know, you or me that we don’t have a financial problem with that amount, they’re looking for people who are eligible for that and or maybe already on Medicaid, and they’re looking to sell them a policy. Or to change their policy.

So, Medicare is not, you know, they’re never going to call you, IRS is never going to call you. Unless you’ve maybe made arrangements for a callback. Social Security is never going to call you, so you know you just don’t want to be talked to. You just don’t want to be talking to anybody that, you know, calls you out of the, you know, out of the blue on the phone, no matter what it’s, you know, it’s not safe.

And you need To protect your Medicare Card, just as you would your Social Security card. 

My opinion is, you know when you’re 80 years old or whatever, you don’t even need to be carrying your social security card with you. I can’t imagine where you’re going to have a situation where you know you need to pull out the Social Security card, but you need to protect that Medicare card because that’s the new Social Security card. You know, on the black market? You know, Medicare numbers are becoming as important as a charge card number or Social Security number. 

Joel 

Is that because bad actors can order medication using it? 

Bruce 

Well, yeah, they can, you know, use it to, you know, file false claims. You know things like that. You know, you don’t want all of a sudden to go to the doctor because you know you need a kidney transplant, and you know that. Oh, wait a minute. You had one, four years ago? No, I never had it, you know. 

Joel 

Oh, my goodness. 

Bruce 

So yeah, so that’s. You know what? What you have to do but you know, for anybody in general. You know, let’s face it, after a certain age. Don’t answer. Don’t talk to them. Don’t try out with them because they’re professional scammers. They’re way better than you or me in conning us so you don’t want to talk to them at all. Don’t pick up that phone number that you don’t know. You know, of course, even a lot more seniors are on, you know, on the computer now. And boy, it’s awful tough not to see that e-mail that talks about whatever savings you might get on doing something. So, it’s, you know, harder and harder to decline, opening up an e-mail that shouldn’t be opened up. 

Joel 

Well, I appreciate that, and thank you for your time. 

So just to get back to give the answer to our little Riddle, the more steps you take, the more you leave behind what am I? The answer is footsteps. The more you take, the more you leave behind, yeah, so. I got some brain juice. 

Nicole 

I had no guests at all. 

Bruce 

No, I kept of course I was not thinking. I was thinking. Well, wait a minute now. What could you know what could that be? That’s pretty, yeah. That’s pretty good. 

Joel 

Well, thank you for joining us, Bruce, and I hope you have a great day. Thank you, everyone, for joining us online. I hope you have a great week and join us. Next time, thank you. 

Nicole 

Have a good day. 

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